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1053536110
TERESA L LEATHERLAND
LAFAYETTE, IN
NPI
1053536110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
246ZS0410X Specialist/Technologist, Other, Surgical Technologist
(Licence: IN 102773)
Enumeration Date
2007-04-16
Last Update Date
2007-07-08
Business Address
-- TERESA L LEATHERLAND CST
904 SOUTH ST
LAFAYETTE, IN 47901-1416
Phone number: 765-742-2441
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Mailing Address
-- TERESA L LEATHERLAND CST
PO BOX 4699
LAFAYETTE, IN 47903-4699
Phone number: 765-742-2441
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